New tool for recognizing physician distress, preventing suicide

Timothy M. Smith
Senior Staff Writer
AMA Wire
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Physicians die by their own hands at much higher rates than do members of the general public—40 percent higher in males and 130 percent higher in females—so recognizing and responding to physician distress is crucial. Physicians themselves are uniquely positioned to do this for their colleagues, but many are uncomfortable intervening and unsure what steps to take if they do get involved. A new resource offers guidance in successfully identifying distressed colleagues and helping them get the care they need.

Risk factors for physicians may be similar to those for the general public, but many physicians feel their identities are closely tied to their professional images, and this makes them more vulnerable to distress when problems arise at work.

Almost every state in the nation has a physician health program (PHP), and the Federation of State Physician Health Programs maintains a listing of state PHPs with a description of the services provided by each. State PHPs may even be able to assist physicians in identifying others with experience and expertise in treating distressed physicians.

Still, physicians are often reluctant to access care.

Care for your colleagues, care for yourself

If you believe a physician colleague is displaying signs of distress, how should you approach her or him? How can you teach your care team to recognize physicians in distress or at risk for suicide? What actions can you take to support them?

Preventing Physician Distress and Suicide, a new module from the AMA’s STEPS Forward™ collection of practice improvement strategies, focuses on the unique vulnerability and treatment needs of physicians.

It includes four steps to identifying at-risk physicians and referring them to appropriate care:

  • Talk about the risk factors and warning signs for suicide. Risk factors can range from relationship problems to being named a defendant in a lawsuit. Warning signs can be as obvious as mood changes and increased alcohol use.
  • Take steps to standardize care-seeking in your organization. One easy step is encouraging colleagues to take time off for vacation and sick leave.
  • Make it easy to find help. For starters, be sure to post referral lists for resources inside and outside your organization in a highly visible location that does not require a password, and assure users that there is no tracing of page visits or downloads.
  • Consider creating a support system for physicians in your organization. This can include simply reducing a physician's patient caseload and offering regular screenings for depression.

The module also features sample scenarios, scripting for approaching distressed physicians, a self-assessment for medical malpractice stress syndrome, a list of suicide prevention resources and other downloadable tools.

And don’t forget: Self-care is one of the most visible ways to standardize care-seeking in your practice. Allow yourself time to recharge, talk about your own stress, say “no” when you need to and learn to recognize the signs of distress in yourself.

There are seven new modules now available from the AMA’s STEPS Forward collection, bringing the total number of practice improvement strategies to 42, thanks to a grant from and collaboration with the Transforming Clinical Practices Initiative.


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i feel that the most important point of this article was the statement that physicians over identify with their work. In a society that minimizes the idea that physicians are facilitators of healing which is in the province of the Divine, (the "God-complex") physicians assume excessive and actually misguided responsibility for outcomes. We might want to look at whether or not doctors who have daily spiritual practices embedded in their lives have the same statistics. <br/> <br/> Additionally,the trend we are seeing of younger physicians veering away from private practice into large health organizations stems from the crushing paperwork associated with insurance issues. Strangely, we do not see the stress being ameliorated. This may be because physicians feel increasingly disassociated from their patients, and are subject to doling out quantity versus quality care. <br/> Prevention is always better than treatment for all of us. This article is very important and more should be written and discussed on matter. Charity and healing begin at home.
Thanks to AMA for creating and making this program available even to non members. It contains much helpful information and useful resources. I also maintain a website devoted to the prevention of physician suicide, at <a href="" rel='nofollow'></a><br/> <br/> Readers might also want to hear my "Ethics Talk" podcast from the October 2016 AMA Journal of Ethics, at <a href=",">,</a> which expands on some of the considerations that may deter physicians from seeking treatment for mental health concerns. This issue was also mentioned at this week's White House conference on suicide prevention, after a recent survey by Gold et al revealed that women physicians in particular may avoid help seeking for fear of professional repercussions. <br/> <br/> We can all begin to do more to keep ourselves healthy, to reach out to and support colleagues in distress, and to make it safer for colleagues to receive needed mental health care without fear that their careers may be upended.
I think mood stabilizers ,anti depressants and SSRIs are great to stabilize patients in a clinical setting.And are not working all that well for long term treatment.Maybe you should try DMT at the very least you let them die twice.And if there is speculation cannabis is working.Against what was said earlier.If you don't believe in your medicine maybe you that should change.
The root cause is that medical school admissions are based on the fantasy that bright students get auto-entrance. Gone is an all-around friendly person that is mature socially, intelligent, has other interests other than money & ego. A "B+" student that is compassionate, dedicated and hard working will have a happy home, happy patients, will give many years of better medical care than a non-listening non-communicative whiz in calculus. If you don't listen to a patient you make dumb conclusions; that's why they are poor physicians, can't understand why they are not successful. Eventually they are hostile enough to commit suicide - the epitome of "They will be sorry when I'm gone!" (Omit bipolar etc. & also we need the extra-bright for research) This is also why medical errors are more prevalent than they should be. My own case is an example: The surgeon said this is a "new procedure". (it was an experimental procedure and happened immediately following.) Years after I recovered my cognition and still unable to work in my beloved profession, I told him it was from the procedure. Angrily, his answer-"It had nothing to do with it"!
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